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Thank you and may god bless her and you ! She's a brave lady !
Anyone had 3 valve replacement surgeries?
- Thread starter Earthsciencerocks
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Yes, she is!
She never complained once during her recoveries from OHS, always did what she was told and most importantly, she walked, walked and then walked! She would walk the hospital halls day and night as she knew that was the ticket to recovery and getting out of there. So after you wake up from surgery, her advice to you is to "get up and move your butt!".
Springdogg
Member
2009 - Cadaver tissue value
2016 - Bovine tissue value
Currently getting an echo yearly as mild leaking has been identified. Current plan is to go with a mechanical valve to avoid any additional surgery. I was 26 in 2009 and am 41 now. With tissue valves, no warfarin and regular INR checks....I would forget I even had AVR. Since the last valve I have been married and have a daughter. I am physically active and fit for surgery. The only thing I wish is that the new artificial valves that have intent to last forever are were available. I could go through the rest of my life never thinking about my AVR.
2016 - Bovine tissue value
Currently getting an echo yearly as mild leaking has been identified. Current plan is to go with a mechanical valve to avoid any additional surgery. I was 26 in 2009 and am 41 now. With tissue valves, no warfarin and regular INR checks....I would forget I even had AVR. Since the last valve I have been married and have a daughter. I am physically active and fit for surgery. The only thing I wish is that the new artificial valves that have intent to last forever are were available. I could go through the rest of my life never thinking about my AVR.
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Amen!
At my current age of 88 my mechanical valve probably will last "forever"......but I doubt any of us has lived our lives without thinking about the mechanical valve we have.....I know I think about it a little most every day. Correct Warfarin management is not difficult and you should "get a handle on it" in no time. BTW, welcome to the Forum.
pellicle
Professional Dingbat, Guru and Merkintologist
probably not entirely a good idea, because you still have the underlying condition (bioprosthetic heart valve disease and perhaps also connective tissue disorder) and you will still need to attend studies to check its all ok.
I got away with it (not getting checked up), thought I was "fixed" as every prior check-up indication had been good for some years. During the last ten years of this I basically wasn't even in the country (Australia) most of the time and it was only by chance that I came back (for other, unscheduled reasons). When I did get a check up they found my aneurysm and it was in a dangerous point of development. It was only found because "I thought I probably should go get checked".
My aneurysm would have killed me. Note; at that time I had had a homograft done in 1992, which (when implanted) it was suggested may perhaps be a permanent solution. It nearly was as I would no doubt have died on the trip I was planning (ski trip) and perhaps left my wife in a traumatised and life threatening situation.
So now I've got a mechanical valve and apart from the changes of taking a pill every day and self testing weekly I've only got the other changes to get used to (like aging).
My advice is don't try to pretend that you're fixed now; while the anniversary is irrelevant the ongoing check-ups aren't.
Best Wishes
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Just had my 2nd surgery at 67 and have had some good days but some bad days. Last night my hear rhythm was off and still have fluid on a lung. When this new valve wares out my 3rd valve replacement will be tavet.
i hope that they figure out how to fix your mitral via the clips.
otherwise the best solution may be a mechanical in the hands of a surgeon who is a reop specialist (those do exist).
my reop surgeon had done 6th avr before without a problem and had outstanding mortality and morbidity rates on very complex reops.
perhaps best solution
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Hi Rebecca.
Congratulations on coming through your second surgery!
Congratulations on coming through your second surgery!
Out of curiousity, who is promising you that your next procedure WILL be a TAVR? We see a lot of these promises and in reality there is a lot of disappointment when patients learn that they are not eligible for TAVR. I'm not clear about what % are eligible, or if there has actually been a study to determine this, but anecdotally it seems that most are not eligible when it comes time for their evaluation. I know that when my stenotic native valve was evaluated that it was determined that I was not eligible. In reality, I would say that the best one can say is that they "hope" to be eligible for TAVR on the next round.
Springdogg
Member
I see my cardiologist twice a year and now also have a yearly echo. I am just saying that I don't think about my AVR on a day to day basis.
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Rebecca got 12 years out of her first valve. At 67 now, she may never need a third replacement.
Hello,
So met with cardiologist, following CT scan, and TAVR surgeon and we agreed that TAVR will be very LOW on my list of choices. I have bovine 23mm valve and patient mismatch would be the result of a TAVR.
I'm planning on a mechanical SAVR. Most likely a Medtronic Open Pivot Standard (ATS) as big as they can stuff in there. Thank-You pellicle for the always amazing logical data driven articles helping my choice!!!
We meet with surgeon June 25th, followed by scheduling surgery date.
Something that keeps replaying itself in my head is how my last surgeon (2nd AVR surgery) told us third surgery probably won't be an option due to so much scar tissue, adhesions, etc.
But, I'm meeting with an amazing surgeon that I pray will review last surgery notes and come up with a workable plan.
Positives are I've lost 40lbs and am no longer obese (BMI), not diabetic, no renal failure, no endorcaditis, it will be a planned surgery (hopefully) not emergency like last one, calcified bovine valve still working but poorly, I'm asymptomatic for now, am much healthier than last AVR, work out 5 days a week with the blessing of my cardiologist.
So, we'll see what the angiogram shows next week. And, followed in 2 weeks with appointment with surgeon.
My history is: 2007 27mm Medtronic Freestyle porcine AVR, 2016 23mm Edwards Magna bovine AVR.
God bless all those out there! We can do this! Godspeed your recoveries!
So met with cardiologist, following CT scan, and TAVR surgeon and we agreed that TAVR will be very LOW on my list of choices. I have bovine 23mm valve and patient mismatch would be the result of a TAVR.
I'm planning on a mechanical SAVR. Most likely a Medtronic Open Pivot Standard (ATS) as big as they can stuff in there. Thank-You pellicle for the always amazing logical data driven articles helping my choice!!!
We meet with surgeon June 25th, followed by scheduling surgery date.
Something that keeps replaying itself in my head is how my last surgeon (2nd AVR surgery) told us third surgery probably won't be an option due to so much scar tissue, adhesions, etc.
But, I'm meeting with an amazing surgeon that I pray will review last surgery notes and come up with a workable plan.
Positives are I've lost 40lbs and am no longer obese (BMI), not diabetic, no renal failure, no endorcaditis, it will be a planned surgery (hopefully) not emergency like last one, calcified bovine valve still working but poorly, I'm asymptomatic for now, am much healthier than last AVR, work out 5 days a week with the blessing of my cardiologist.
So, we'll see what the angiogram shows next week. And, followed in 2 weeks with appointment with surgeon.
My history is: 2007 27mm Medtronic Freestyle porcine AVR, 2016 23mm Edwards Magna bovine AVR.
God bless all those out there! We can do this! Godspeed your recoveries!
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As this will be OHS #3, I believe you are making a wise decision. Hoping that this will be your last one and with a mechanical valve, it will likely be your last.
Wishing you the very best of luck with your procedure. Please keep us posted.
You're doing all the right things to prepare! I'm sure it will go well.
pellicle
Professional Dingbat, Guru and Merkintologist
Good morning
you're welcome, but I want to say that while I have an ATS (and it came with benefits that I did not know about at the time and may not apply to you) you should also consider the St Jude, not least because it has such a good and long history, but because its one of the best for appearing to deliver on its specifications. In this post (link) I have presented a table (and the citation from where) in support of a discussion about valves and expectations. I would encourage you to read that. A note worth making is that; in that I coloured two valves, one red and the other green because they were the valves under discussion, I did not add that colour for any other reason.
If your sugeon prefers the ATS then I would go with what he likes because there is more to a successful surgery than the valve, there is the technique of fitting it.
My own surgeon on my 3rd (consult my bio) would be important because "you really don't want a 4th" ...
Yep ... you don't want a #4 ...
Best Wishes
yep
wise choice at this stage ...
you're welcome, but I want to say that while I have an ATS (and it came with benefits that I did not know about at the time and may not apply to you) you should also consider the St Jude, not least because it has such a good and long history, but because its one of the best for appearing to deliver on its specifications. In this post (link) I have presented a table (and the citation from where) in support of a discussion about valves and expectations. I would encourage you to read that. A note worth making is that; in that I coloured two valves, one red and the other green because they were the valves under discussion, I did not add that colour for any other reason.
If your sugeon prefers the ATS then I would go with what he likes because there is more to a successful surgery than the valve, there is the technique of fitting it.
that's not strictly correct, I'd phrase it as "due to scar tissue, adhesions (which are a form of scar tissue) that a 3rd surgery will be more difficult".We meet with surgeon June 25th, followed by scheduling surgery date.
Something that keeps replaying itself in my head is how my last surgeon (2nd AVR surgery) told us third surgery probably won't be an option due to so much scar tissue, adhesions, etc.
My own surgeon on my 3rd (consult my bio) would be important because "you really don't want a 4th" ...
excellent!!
I'll be keeping a close watch on your progress ...
Yep ... you don't want a #4 ...
Best Wishes
Gail in Ca
Well-known member
You are approaching your 3rd surgery with a great attitude! It puts the positive vibes out into the universe.
I awoke from #3 feeling so good. I did spend an extra day in ICU, so I guess the partial collapsed lung caused that. I know I was mostly ignored in that section of ICU, so I think it was just precautionary.
After that, my recovery went very well.
I’m thinking positive thoughts for your 3rd to go that well!
I awoke from #3 feeling so good. I did spend an extra day in ICU, so I guess the partial collapsed lung caused that. I know I was mostly ignored in that section of ICU, so I think it was just precautionary.
After that, my recovery went very well.
I’m thinking positive thoughts for your 3rd to go that well!
@Earthsciencerocks
I think that the ATS is a great choice. All of these valves are very similar, but they have specific benefits. There is some research to suggest that you dont hear the ATS as much as other valve due to the open pivot design. It is also the only valve with one study (yes only one, but pretty good quality) to suggest that the valve can handle INR 1.5-2.5 without any aspirin. I am not suggesting that your keep your INR there, but this means that if your INR does fall below 2, there is no reason to stress all that much.
I have an ON-X. I am happy with my choice, since the valve has pretty good hemodynamics. My mean and peak gradient is 5 and 10, which apparently is very low. But the On-X is superloud. At least in my body. I am pretty skinny (BMI 22, H 190cm, W 81kg) and I have an aortic graft, so perhaps there are some echo chamber effects. Nevertheless, my 8 year old can hear the valve from 5 meters away - yes you read that right.
Best of luck with your surgery. I am sure you are in great hands.
Finally, it is just the matter of finding the right surgeon. On #2, I found a surgeon who specialised in reops. He told me replaced someone's AVR for the sixth time before successfully.
I will keep my fingers crossed for you.
I think that the ATS is a great choice. All of these valves are very similar, but they have specific benefits. There is some research to suggest that you dont hear the ATS as much as other valve due to the open pivot design. It is also the only valve with one study (yes only one, but pretty good quality) to suggest that the valve can handle INR 1.5-2.5 without any aspirin. I am not suggesting that your keep your INR there, but this means that if your INR does fall below 2, there is no reason to stress all that much.
I have an ON-X. I am happy with my choice, since the valve has pretty good hemodynamics. My mean and peak gradient is 5 and 10, which apparently is very low. But the On-X is superloud. At least in my body. I am pretty skinny (BMI 22, H 190cm, W 81kg) and I have an aortic graft, so perhaps there are some echo chamber effects. Nevertheless, my 8 year old can hear the valve from 5 meters away - yes you read that right.
Best of luck with your surgery. I am sure you are in great hands.
Finally, it is just the matter of finding the right surgeon. On #2, I found a surgeon who specialised in reops. He told me replaced someone's AVR for the sixth time before successfully.
I will keep my fingers crossed for you.
Great info on St. Jude! I'm assuming that goes for SJRegent and SJMasters from what I've been researching. I'll add them to my top 3 choices. Thanks for your wisdom pellicle!
pellicle
Professional Dingbat, Guru and Merkintologist
Morning
for whatever reason I read this article about the ATS some time back (I have the full text, because some time back I worked in a University Library).
https://pubmed.ncbi.nlm.nih.gov/16928497/
now bear in mind that it is not related to your situation (nor mine) because it is specifically about the 19mm valve size.
Before going further I want to make clear the following points:
Leaflet opening angles of ATS valves in vivo tend to be less than those reported by the manufacturer, and there is a wide variation in opening angles even among valves of the same size.
ATS valves 21 mm or larger (72.2° ± 3.8° in 21-mm, 72.4° ± 2.8° in 23-mm, and 72.8° ± 2.9° in 25-mm valves). {pellicle: note this variation is different from the figures obtained by the study I mentioned above. This is something to keep in mind; not all studies give the same measurements}
This image helps one to understand the geometry of the opening and closing measurements and how they are obtained.
worthy of note is the difference in trimming of the wire ties in the above image.
lastly, this is my own X-Ray of my wire state post sugery (and pre my debridement from infection surgeries).
Yellow circles give examples of various metal junk left lying around from god only knows which of my 3 surgeries (I suspect #1 more than #3)
Note also the traces of old wires which remain "trapped in the bone" as leftovers from the two prior surgeries. 20 years of being there means "staying there".
A point to consider (which I did) is: what happens if an infection in the chest finds those place to hide in ... answer = "they remove the whole bone. We have had members here undergo this (and one of my friends fathers underwent this exact solution to an infection issue.
This is part of the risks of why you don't want to plan for multiple OHS.
HTH
for whatever reason I read this article about the ATS some time back (I have the full text, because some time back I worked in a University Library).
https://pubmed.ncbi.nlm.nih.gov/16928497/
now bear in mind that it is not related to your situation (nor mine) because it is specifically about the 19mm valve size.
Before going further I want to make clear the following points:
- I am not any expert in the haemodynamics of how blood flows around a mechanical valve leaflet and all of the many aspects which must be traded off against one another to make a valve "ideal" (note: none are)
- an important part of this opening and closing jet pressures (to my understanding is turbulence is less so) for these produce pressure sufficient to begin to trigger platelets which will then lead to their aggregation and the formation of floating emboli (aka clots)
- to restate the first point in a different way I can not make any conclusions about the difference between opening and closing angles and their pros and cons in the body
Leaflet opening angles of ATS valves in vivo tend to be less than those reported by the manufacturer, and there is a wide variation in opening angles even among valves of the same size.
ATS valves 21 mm or larger (72.2° ± 3.8° in 21-mm, 72.4° ± 2.8° in 23-mm, and 72.8° ± 2.9° in 25-mm valves). {pellicle: note this variation is different from the figures obtained by the study I mentioned above. This is something to keep in mind; not all studies give the same measurements}
This image helps one to understand the geometry of the opening and closing measurements and how they are obtained.
worthy of note is the difference in trimming of the wire ties in the above image.
lastly, this is my own X-Ray of my wire state post sugery (and pre my debridement from infection surgeries).
Yellow circles give examples of various metal junk left lying around from god only knows which of my 3 surgeries (I suspect #1 more than #3)
Note also the traces of old wires which remain "trapped in the bone" as leftovers from the two prior surgeries. 20 years of being there means "staying there".
A point to consider (which I did) is: what happens if an infection in the chest finds those place to hide in ... answer = "they remove the whole bone. We have had members here undergo this (and one of my friends fathers underwent this exact solution to an infection issue.
This is part of the risks of why you don't want to plan for multiple OHS.
HTH
Gail in Ca
Well-known member
I had my wires removed after the 2nd and 3rd surgeries, within a year of the surgeries because they protruded and bugged me, and my surgeon was fine with my removal request.
